There are basically six different types of medical tests which may be performed on a patient, and for various reasons, using specialized equipment, including: analysis of bodily fluids (blood, urine, spinal cord & brain-cerebrospinal fluid, joint fluid-synovial fluid); imaging (x-rays, ultrasonography, radioisotope scanning, computed tomography—CT, magnetic resonance imaging-MRI, positron emission tomography-PET, and angiography); endoscopy (nose, mouth, anus, urethra, and vagina); tissue biopsy (skin, breast, lung, liver, kidney, and bone); genetic testing; and measurement of bodily functions (brain-electroencephalography or EEG, heart-electrocardiography or ECG, and muscle strength and range or motion).
The measurement of bodily function, particularly with regard to physical impairment, plays an important and intertwined role between the medical community—as to diagnosis, treatment, and treatment affectivity—and the legal community—as to liability and damages. A person's level of impairment is significant for tort liability due to automobile and other accidents, and also as to on-the-job work-related accidents, which are governed by state and federal Worker's Compensation Law, and Social Security disability claims. A list of impairments that Congress has determined to be disabling are found in the disability handbook, which is called Disability Evaluation under Social Security, or more commonly known as the Blue Book. The handbook, which may be found electronically at socialsecurity.gov, lists the categories of impairments, which include impairment of the musculoskeletal system.
The Social Security Administration (SSA) defines a medically determinable impairment as “an impairment that results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques.” But, the Social Security rules create a system where a person is either entirely disabled or not disabled at all. However, rating the degree of impairment is essential in workers compensation cases. According to the fifth edition of the “Guides to the Evaluation of Permanent Impairment,” published by the American Medical Association (AMA), impairment is defined as “an alteration of an individual's health status; a deviation from normal in a body part or organ system and its functioning.” The AMA Guides also hold that impairments that are to be rated are permanent impairments, meaning one that has reached maximum medical improvement (MMI) and is well stabilized and unlikely to change substantially in the next year with or without medical treatment.
Although individual state law governing workers' compensation provides its own unique definition of impairment, they are generally consistent with the definition found in the AMA Guides. In fact, while about fourteen states either use state-specific guidelines or do not specify a specific guideline, some thirty-six states use the AMA Guides 2nd, 3rd, 4th, 5th, and 6th editions. The fifth edition is currently the most popular, seeing usage by sixteen states. Therefore, a person's physical impairment rating is a critical factor in many states.
To appropriately adjudicate a claim, it is essential to use a functional evaluation that provides an accurate and unbiased clinical understanding of a person's true physical ability. Without this objective information, inappropriate claim decisions can result in increased lost time, unnecessary treatment and the opportunity to abuse the claims process. This is unacceptable for all parties who expect an equitable resolution of a claim.
This invention makes use of protocols to standardize a process and a computer program. Such an approach within the medical community is, by itself, not new. The use of protocols was demonstrated in related art shown by U.S. Pat. No. 5,833,623 to Mann for “System and Method for Facilitating Rapid Retrieval and Evaluation of Diagnostic Data Stored by an Implantable Medical Device,” and U.S. Pat. No. 5,873,894 to Vandegriff for “Diagnostic Test Protocol in an Implantable Medical Device.” The former records diagnostic heart data for later retrieval and evaluation, not unlike systems used for recording seismic data. The latter arrangement provides for communication between the medical device and the programmer, including an output signal to transmit information on the status of the medical device. But both inventions are narrowly focused on heart pacemaker activity and other devices similarly implanted in the human body.
In U.S. Pat. No. 6,827,670 to Stark for “System for Medical Protocol Management,” the invention is targeted at providing an appropriate orthopedic treatment protocol with modification of the treatment based on feedback data recorded by a computerized orthopedic treatment device, and analyzed by an interaction algorithm. However, the analysis is based on orthopedic treatment protocols, using challenge levels associated with an injury, but does not specify the evaluation means or the standards used for evaluating functional abilities.
However, the invention disclosed herein is a unique merger of resources to obtain synergy specifically directed at producing repeatable, consistent impairment ratings, through use of a specialized functional evaluation. The resources comprise: a range of selectable standards for evaluation, including the different editions of the AMA guides; a computer program particularly designed to amass empirical test data in accordance with the standard selected; a wide variety of evaluation protocols, and testing tools, many of which have been modified to input data directly into the computer diagnostic program, in addition to the option of making manual entries; and automatic report generation.